Miscellaneous Infections of the Gastrointestinal Tract

Diarrheal diseases are a very common reason why patients consult their doctor. Acute diarrhea lasts no longer than 2 weeks and has usually a rather mild course; however, if the diarrhea becomes more severe or is persistent, it can pose a serious health problem. Diarrheal diseases are most commonly due to infections. Chronic diarrhea represents a challenge to any doctor’s diagnostic skills as there are a multitude of differential diagnoses. In the following article, we will present you with all the important information you might need for clinical exams and clinical practice.

00:01
What we´ll do next is take a look at viral, non-bloody diarrhea.
00:04
The most common diarrhea that we see in children with viruses here.
00:09
This is viral diarrhea. We just completed our discussion of bacterial diarrhea.
00:12
With viral diarrhea, rotavirus being the most common.
00:15
Symptoms begin 3 to 7 days, upon exposure to that particular environment.
00:22
By environment, I´m referring to the fact that the childmight be playing during the winter months in daycare centers and such.
00:28
In these closed quarters, it´s when they would perhaps increase their chance of acquiring rotavirusor may be perhaps in a closed quarter, one of the most common causes of pneumonia in childrenwould be your RSV (Respiratory Syncytial Virus), so keep those in mind.
00:46
Maybe perhaps you take a cruise on... I´m joking here so that we can help you out.
00:52
But on Norwegian croissants and so therefore, 'Welcome to Norwalk Virus'.
00:58
What I mean by that is the fact that where you would be exposed in Norwalk viruswould be a population that has just been on a cruisein which they have now all eaten out of a buffet resulting in diarrhea, diarrhea, diarrhea.
01:12
Supportive therapy because with viruses we don´t necessarily absolutely havespecific treatment to get rid of a virus.
01:21
Supportive therapy in terms of dehydration and to control that fever.
01:26
Next, getting away from your virus, we have something called Giardiasis.
01:32
Giardiasis is Giardal lamblia and with Giardal lamblia you might be thinking aboutpatients that are hikers and during a hike, you can have exposure to the waterand being contaminated by Giardal lamblia (camping), stool antigen testing.
01:51
Treatment here would be metronidazole.
01:53
Next topic is amebiasis. What happens here is the fact that the patient has gone tolet´s say endemic areas and you should be thinking about organismssuch as entamoeba hystolitica and you've heard of anchovy paste or type of appearance on the liver,get away from that. What that anchovy refers to is the fact thatthere´s complete liquefacting necrosis taking place within in the abscess in the liver.
02:19
Organism here is something like your entamoeba histolytica.
02:24
The treatment here would be Metronidazole.
02:26
I´m going through this really quick because you´ve had all of these with Micro.
02:30
All we're doing now is just a process of reinforcement,why not have different people tell you the same thing in different ways so that this information sticks.
02:38
Our topic is tuberculosis type of diarrhea, your ileocecal area. Think about where that is.
02:45
The ileocecal. You´ve just left the ileum, you´ve entered the cecumand here and once again mimics your Crohn´s disease with deep ulcers.
02:54
Biopsy will give you, well, confirms what´s known as your acid fast bacillion Ziehl´ Neelsen stain and that acid-fast bacilli PCR is not available, alright?But the Ziehl´ Neelsen stain? Sure.
03:09
Streptococcus bovis endocarditis associated with colon cancer and diverticulosis.
03:16
I recommend colonoscopy. When you have streptococcus bovis endocarditis,oftentimes, diarrhea is in fact associated. Keep that in mind.
03:25
Therefore you wanna make sure that you´re being efficientand aware that there might be colonic issues as well with the bovis.

About the Lecture

The lecture Miscellaneous Infections of the Gastrointestinal Tract by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

Included Quiz Questions

Which of the following is the most common virus associated diarrheal disease?

Rota virus

Norwalk virus

Noro virus

Calici virus

Echo virus

A patient complains to the cruise captain about experiencing diarrhea since the afternoon. Which virus usually causes this presentation?

Norwalk virus

Rota virus

Flavi virus

Calici virus

Echo virus

A parasite in the stool microscopy shows falling leaf motility in a hiker's stool analysis. Which parasite can cause this presentation?

Giardiasis

Trichomonas

Ascariasis

Entamoeba histolytica

Necator americanus

Which of the following is NOT related to amebiasis?

It is called traveler's diarrhea

It causes colitis

It causes liver abscess

It causes discrete deep ulcers

It is caused in patients traveling to an endemic country

Which cancer is associated with streptococcus bovis endocarditis?

Colon cancer

Renal cancer

Thyroid cancer

Liver cancer

Pancreatic cancer

Author of lecture Miscellaneous Infections of the Gastrointestinal Tract

Carlo Raj, MD

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